Izicwangciso zoLuhlu lweeMedare: Ngubani oBanikayo kunye nendlela yokuBhalisa

Umxholo

• Yintoni i-Medicare Advantage (Medicare Part C)?
• Ngubani othengisa izicwangciso zenzuzo yeMedare?
• Ixabisa malini i-Medicare Advantage?
• Iingcebiso zokukhetha isicwangciso seMedare
• Ngubani ofanelekileyo kwizicwangciso ze-Medicare Advantage?
• Ixesha elibekiweyo lokubhaliswa kwamayeza
• Ukuthatha

Uncedo lweMedicare lolunye ukhetho lweMedicare olubandakanya ukugubungela amayeza amiselweyo, amazinyo, umbono, ukuva, kunye nezinye izinto zempilo.

Ukuba usandula ukubhalisa kwi-Medicare, usenokuzibuza ukuba ngubani othengisa izicwangciso ze-Medicare Advantage kwindawo yakho. Uncedo lweMedicare lunikezelwa ziinkampani zeinshurensi zabucala ezinesivumelwano neMedicare zokugubungela iinkonzo zakho zokhathalelo lwempilo.

Kule nqaku, siza kuphinda sihlolisise into ofuna ukuyifumana malunga ne-Medicare Advantage, indlela yokubhalisa, kunye nento ongayilindela kwiinkampani ezibonelela ngezi zicwangciso.

Yintoni i-Medicare Advantage (Medicare Part C)?

Uncedo lweMedicare, ekwabizwa ngokuba yiMedicare Part C, kukugubungela iMedicare ethengiswa ziinkampani zabucala zeinshurensi. Ukongeza kokugubungela i-Medicare Icandelo A kunye neCandelo B, uninzi lwezicwangciso ze-Medicare Advantage zikwagubungela amayeza amiselweyo, kunye namazinyo, umbono kunye neenkonzo zokuva.

Amanye amacandelo e-Medicare Icandelo C ade agubungele izinto zempilo ezinje ngobulungu bokuqina komzimba kunye neenkonzo ezithile zekhaya.

Uninzi lwezicwangciso ze-Medicare Advantage zigubungela ezi nkonzo zilandelayo:

• Ukunyamekela esibhedlele
• Iinkonzo zonyango ezingalaliswayo
• amayeza amiselweyo
• wamazinyo, umbono, kunye nokhathalelo lokuva
• ezongeziweyo ezempilo

Izicwangciso ze-Medicare ze-Advantage zinokuba yinto efanelekileyo kubantu abafuna ukhuselo olongezelelekileyo ngaphaya kwamacandelo e-Medicare A kunye no-B kwaye bazibopha zonke phantsi kwesicwangciso esinye.I-Medicare Icandelo C ikwayindlela ekhethwayo kubantu abafuna ukukhetha kwizakhiwo ezahlukeneyo, ezinje nge-HMOs, ii-PPOs, kunye nokunye.

Okokugqibela, ucebise ukuba i-Medicare Advantage inokukugcinela imali xa ithelekiswa ne-Medicare yoqobo xa kuziwa kwindleko yezixhobo zonyango.

Ngubani othengisa izicwangciso zenzuzo yeMedare?

Izicwangciso ze-Medicare eziluncedo zithengiswa ziinkampani ezinkulu zeinshurensi zabucala, kubandakanya:

• I-Aetna Medicare
• IBlue Cross Blue Shield
• Cigna
• Humana
• UKaiser Permanente
• KhethaHealth
• Ukhathalelo lweZempilo

Amayeza e-Medicare Icandelo C ayahluka ukusuka kurhulumente ukuya kurhulumente, kwaye inkampani nganye yeinshurensi inelungelo lokuthatha isigqibo sokuba bayazithengisa izicwangciso zeMedicare Advantage unyaka nonyaka.

Umzekelo, ezinye iinkampani zinokubonelela ngezicwangciso kwiindawo ezimbalwa ezikhethiweyo kodwa hayi kwezinye. Oku kuthetha ukuba nokuba umhlobo wakho ubhalisele isicwangciso se-Medicare Advantage kwindawo yabo, eso sicwangciso asinakunikwa apho uhlala khona.

Ukuba sele ufumana iinkonzo kumnikezeli omkhulu weinshurensi ngomqeshi wakho, ungafikelela kwaye ubuze ukuba bayazithengisa na izicwangciso zeMedicare Advantage.

Enye indlela yokuphonononga yonke iminikelo yakho yesicwangciso kukusebenzisa isixhobo sokufumana isicwangciso esinikezelwa yiMedicare. Esi sixhobo sikuvumela ukuba ukhangele kwaye uthelekise izicwangciso ze-Medicare Advantage kwisixeko sakho, ilizwe, okanye ikhowudi ye-ZIP.

Ixabisa malini i-Medicare Advantage?

Izicwangciso ze-Medicare Advantage zibandakanya zombini iindleko zonyango lokuqala, kunye neendleko ezithile zesicwangciso. Akukho ndleko zodwa zokubhalisa kwisicwangciso seMedarement Advantage kuba zininzi izinto ezinokuchaphazela into oza kuyihlawula.

Zonke ezi ndleko ziphenjelelwa ngurhulumente apho uhlala khona, iindleko zokuphila, umvuzo wakho, apho uya khona kwiinkonzo zononophelo lwempilo, ufuna iinkonzo kangaphi, nokuba ufumana naluphi na uhlobo loncedo lwezezimali.

Nalu ulwahlulo lwento onokuyilindela ukuba uyihlawule ngo-2021 xa ubhalisa kwisicwangciso seMedicare Advantage:

• Iintlawulo zanyanga le. Ukuba awulungelanga ukungena kwiCandelo A le-premium, iPremiyamu yakho yeCandelo inokuxabisa ukuya kuthi ga kwi-471 ngenyanga. Iiprimiyamu zeCandelo B zibiza i-148.50 ngenyanga okanye ngaphezulu, kuxhomekeke kumvuzo wakho. Ezinye izicwangciso ze-Medicare Advantage ziya kuhlawula ezi ndleko zepremiyamu zenyanga. Ukongeza, ngelixa ezinye izicwangciso ze-Medicare Advantage zingenasimahla, ezinye zikwahlawulisa ipremiyamu yenyanga eyahlukileyo yesicwangciso.
• Ukutsalwa. Icandelo A linemali exhuzulwayo eyi- $ 1,484 ngexesha ngalinye lesibonelelo. Icandelo B linemali exhuzulwayo eyi- $ 203 ngonyaka. Ukuba isicwangciso sakho se-Medicare Advantage sigubungela amayeza amiselweyo, unokufumana ityala lokuchithwa kweziyobisi ngokunjalo.
• Iikopi. Isicwangciso ngasinye se-Medicare Advantage siya kuba nexabiso elithile lokuhlawula ngokutyelela oogqirha kunye noochwephesha. Ezi zixa-mali zinokwahluka ngokuxhomekeke kubume besicwangciso sakho nokuba ngaba ufumana iinkonzo kumnxibelelanisi wothungelwano okanye ongaphandle kwenethiwekhi.
• UQinisekiso. Icandelo Isiqinisekiso semali sinokuxabisa nje nge- $ 0 okanye kangange-742 yeedola ngemini, kuxhomekeke kubude bokuhlala kwakho esibhedlele. Icandelo B ukuqinisekiswa kweemali zeepesenti ezingama-20 zazo zonke iinkonzo zezempilo ezivunyiweyo emva kokutsalwa.

Iingcebiso zokukhetha isicwangciso seMedare

Xa ujonge esona sicwangciso silungileyo seMedicare seMfuno zakho, jonga oku kulandelayo:

• uhlobo lokugubungela olufunayo, olunokuthi lube nefuthe kuhlobo luni lwesicwangciso osikhethayo kwaye loluphi uhlobo lwesicwangciso sokubonelela ekufuneka ujonge kuso
• ubungakanani bokubanikezela kokubonelela okudingayo, okunokukunceda ufumanise ukuba loluphi uhlobo lwesicwangciso sesibonelelo sokungena ukuze ubhalise
• I-avareji yenyanga kunye nonyaka yokuphuma epokothweni kweendleko onokuthi uzibambe, ezibandakanya iipremiyamu, iimali ezixhuzuliweyo, iikopi, ukuqinisekiswa kwemali, iindleko zamachiza amiselweyo, kunye neemali ezingaphandle kweepokotho
• ufuna kangaphi ukhathalelo kwaye loluphi uhlobo lononophelo olufunayo, olunokukunceda ubhalise kwisicwangciso esihlangabezana neemfuno zakho zezemali nezonyango

Emva kokuba uqwalasele yonke imiba enxulumene nemeko yakho yobuqu, ungasebenzisa ukufumana isixhobo sesicwangciso seMedicare ukufumana isicwangciso seMedicare Advantage ngqo esiya kukunceda kakhulu.

Ngubani ofanelekileyo kwizicwangciso ze-Medicare Advantage?

Nabani na obhalise kwi-Medicare Part A kunye neCandelo B unelungelo lokubhalisa kwi-Medicare Advantage.

Ngo-2021, abantu abanesifo sokugqibela se-renal disease (ESRD) banelungelo lokubhalisa kuluhlu olubanzi lwezicwangciso ze-Medicare Advantage ngenxa yomthetho owenziwe yiCongress. Ngaphambi kwalo mthetho, uninzi lweeplani alunakukumkela okanye lukunciphise kwi-SNP (C-SNP) ukuba unesifo esinganyangekiyo ukuba unesifo se-ESRD.

Ixesha elibekiweyo lokubhaliswa kwamayeza

Nje ukuba ukulungele ukubhalisa kwisicwangciso seMedicare Advantage, kuya kufuneka unike ingqalelo le mihla ilandelayo:

Ukuthatha

Uninzi lweenkampani ezinkulu zeinshurensi ejikeleze iUnited States zathengisa izicwangciso zeMedicare Advantage. Isicwangciso seMedicare seCandelo lokunikezelwa asimiselweyo kwaye sahlukile kurhulumente ukuya kurhulumente naphakathi kweenkampani.

Xa ubhalisa kwi-Medicare Advantage, unokulindela ukuhlawula zonke iindleko zokuqala zeMedare kunye naziphi na iindleko zesicwangciso seMedare.

Ngaphambi kokuba ubhalise kwi-Medicare Part C, qiniseka ukuba uphonononge imeko yakho ukuze ukhethe olona khetho lufanelekileyo kwiimfuno zakho zexesha elide zezemali kunye nezonyango.

Eli nqaku lahlaziywa ngo-Novemba 19, 2020, ukubonisa ulwazi ngo-2021 lonyango.

Ulwazi olukule webhusayithi lunokukunceda ekwenzeni izigqibo malunga neinshurensi, kodwa ayenzelwanga ukunika iingcebiso malunga nokuthengwa okanye ukusetyenziswa kwayo nayiphi na i-inshurensi okanye iimveliso zeinshurensi. I-Healthline Media ayihambelani neshishini leinshurensi nangayiphi na indlela kwaye ayinayo ilayisensi njengenkampani yeinshurensi okanye umvelisi kulo naliphi na igunya laseMelika. I-Healthline Media ayikhuthazi okanye ixhase nabani na onokuthi enze ishishini leinshurensi.